Pupils: Localization in Coma • Small, Reactive pupils: Metabolic coma. • Unilateral Fixed, dilated pupil : uncal herniation, PCOM aneurysm. • Bilateral, Large fixed pupils: Midbrain lesion or Death. • Bilateral, midposition, fixed pupils: Transtentorial herniation. • Pinpoint pupils: Pontine ICH, infarct, Opiate poisoning. • Horner's syndrome: sympathetic dysfunction. #Pupils #Localization #Coma #Neurology #differential #diagnosis
